Healthcare FSA or Limited Purpose FSA Claim

When using your Benefits Debit Card or paying out of pocket, you must provide documentation for each eligible expense, such as an itemized receipt or Explanation of Benefits (EOB).

Also, eligible Healthcare FSA and Limited Purpose FSA expenses for you, your spouse, or other eligible dependents must be incurred during the plan year. For specific plan information, log in to your online account.

Required Documentation

For a doctor visit or medical procedure, documentation should include:

Original date of service

Type of service rendered (checkup, physical, surgery, etc.)

Charges for the service

Provider of the service (physician name or facility)

Recipient of service

For drugs and medication, documentation should include:

Copy of the physician’s prescription for over-the-counter drugs and medication

Receipt or documentation from the pharmacy showing the prescription number and date filled

Eligible expenses generally must have been incurred during the current plan year. Log in to your online account or check with your employer for specific rules applicable to your plan.

When will my claim be paid?

Once your claim and all required documentation have been received, the turnaround time for claims processing is generally 5-7 business days.

How will I receive my reimbursement?

The fastest way to receive your reimbursement is through direct deposit. Enroll in direct deposit online by logging in to your online account, accessing your Reimbursement Account portal, and selecting My Profile. Or, you may also elect to receive a mailed check.